1. Field of the Invention
The subject invention relates to surgical apparatus for performing laparoscopic and endoscopic surgical procedures, and more particularly to a surgical clamp apparatus and method for applying the clamp during a surgical procedure.
2. Description of Related Art
During surgical operations in which it is necessary to open the intestinal wall to expose the interior lumen, a surgeon must place a clamp across the intestine above and below the point of entry. Prior art surgical clamping devices for clamping tubular vessels such as the intestines are well known. For example, U.S. Pat. No. 4,976,721 to Blasnik et al. describes a manually operable clamp having parallel jaw members biased in a closed position by a spring which is maintained within a housing portion of the clamp. Other surgical clamps having spring biased parallel jaw members include those described in U.S. Pat. No. 3,509,882 to Blake and U.S. Pat. No. 4,931,058 to Cooper.
A bowel clamp and a detachable applicator for applying the clamp are disclosed in U.S. Pat. No. 3,916,908 to Leveen. In particular, Leveen shows a disposable bowel clamp which comprises two rod members each having a hook structure at one end thereof and an aperture at the opposed end which the hook structure engages. Each of the rods are held within respective jaws of the applicator in such a manner so that the jaws of the applicator, once closed, fasten the rod members securely together, thereby forming a clamp. Once the clamp has been placed on the vessel, the applicator is detached from the clamp and removed for use elsewhere. The apparatus shown in Leveen is limited in application however, to conventional surgical procedures in which the surgeon has direct access to the abdominal cavity.
There is a perceived need in the art for adaptation of a detachable bowel clamp, such as that disclosed in Leveen, for endoscopic or laparoscopic procedures. In these procedures a small incision or puncture is made in the patient's body to provide access for a tube or cannula device which allows insertion of surgical apparatus. Thus, to avoid requiting separate incisions for each instrument having a clamp, there is a perceived need in the art for a clamp detachably mounted to the instrument which could be inserted through a cannula, clamped onto a vessel and which remains there while the instrument which delivered the clamp to the site is withdrawn through the cannula and used to deliver another clamp to the operative site.
Such an endoscopic surgical instrument having a detachable clamp for the bowel would, like other bowel clamps, have atraumatic jaws which are angled and include tabs for preventing the bowel from slipping out. The handle and the jaws of the instrument would also be spring loaded, and as is desirable with endoscopic instruments, the instrument would be rotatable and capable of angling for easier application of the clamp.
While there is a perceived need in the art for the above-described instrument, due to the complexity of such instrument, to date no one has developed an endoscopic instrument which enables the application and withdrawal of detachable bowel clamps. The complexity of such an instrument, and hence the difficulty of its development, is due to the requirements that it be operable at a region remote from the clamp to actuate the jaws of the clamp, detach the clamp, re-attach the clamp at the surgical site, as well as allow for rotation and angling of the instrument.